title: Pregabalin in severe burn injury pain: a double-blind, randomised placebo-controlled trial.
abstract: This randomised, double-blind, placebo-controlled trial assessed the efficacy and tolerability of pregabalin to alleviate the neuropathic component of moderate to severe burn pain. Patients aged 18 to 65 years admitted to a burns unit with a 5% or greater total body surface area burn injury were screened to participate in the trial. Using the Neuropathic Pain Scale (NPS), patients scoring 4 or higher on 'hot' pain or 'sharp' pain were invited to participate. Consenting patients were randomly assigned to receive pregabalin or placebo for 28 days with individual dose titration commencing at 75 mg twice daily to a maximum pregabalin dose of 300 mg twice daily. The primary outcome measure was the patients' daily response to the sharp and hot pain of the NPS. Secondary outcome measures included the remaining elements of the NPS, daily opioid requirement, length of hospital stay, pain at 6 months, and side effects of nausea, vomiting, drowsiness and giddiness. For patients administered pregabalin, the primary outcome measures hot (P = .01) and sharp (P = .04) pain were significantly reduced compared with those in patients administered placebo. Secondary outcome measures of itch, unpleasantness, surface pain, and procedural pain were significantly lower (P < .05) in the pregabalin group. Adverse effects were uncommon, with no difference between the treatment groups. There was no significant difference between the pregabalin and placebo treatment groups with respect to opioid consumption, duration of hospital stay, or pain at 6 months. Pregabalin was efficacious and well tolerated in patients after severe burn injury and whose pain was characterised by features of acute neuropathic pain. In this study, pregabalin was well tolerated and significantly reduced several elements of the neuropathic pain scale including hot pain, unpleasantness of the pain, surface pain, and itch, and also significantly reduced procedural pain.
authors.affiliation: The University of Queensland, School of Medicine, Herston, Brisbane 4029, Australia The University of Queensland, School of Pharmacy, Pharmacy Australia Centre of Excellence, Woolloongabba, Brisbane 4102, Australia Professor Tess Cramond Multidisciplinary Pain Centre, Royal Brisbane and Women's Hospital, Herston, Brisbane 4029, Australia Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Herston, Brisbane 4029, Australia The University of Queensland, Centre for Integrated Preclinical Drug Development, St Lucia Campus, Brisbane 4072, Australia Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organisation - CSIRO Mathematics, Information and Statistics, Royal Brisbane and Women's Hospital, Herston, Brisbane 4029, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Gray
authors.forename: Julie
authors.initials: J
authors.lastname: Kirby
authors.forename: Maree T
authors.initials: MT
authors.lastname: Smith
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Cabot
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Williams
authors.forename: James
authors.initials: J
authors.lastname: Doecke
authors.forename: Tess
authors.initials: T
authors.lastname: Cramond
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002056:Burns / Q000150:complications; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*; D010147:Pain Measurement; D000069583:Pregabalin; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid